A comparison of Amplatz dilators and metal dilators for tract dilatation in mini-percutaneous nephrolithotomy.

ABSTRACT

PURPOSE: Our aim was to compare the different characteristics and outcomes of the Amplatz sheaths and single-step metallic dilators which were used for mini-PCNL procedure in a single institution. METHODS: Retrospective medical records of 236 patients who underwent mini-PCNL were reviewed and divided into Amplatz (n = 151) and metal (n = 85) groups. Perioperative and postoperative data including operative time, fluoroscopy time, hemoglobin decrease, blood transfusion, hospital stay, stone-free rate and any postoperative complication were recorded. RESULTS: The groups were statistically similar in terms of operation time, nephrostomy stay, puncture location and hemoglobin decrease. Compared to the metal sheath group, the fluoroscopy time (3.7 vs 5.9 m, p < 0.001) and the hospital stay (53.5 vs 67 h, p = 0.007) were significantly higher in the Amplatz group. Although final stone-free rate was higher for metal group than Amplatz group, no statistical difference was established (82.1 vs 79.5%, p = 0.285). The rates of complications such as fever, blood transfusion, postoperative DJ insertion were similar in two groups with no significant difference. CONCLUSION: Although different treatment outcomes of various institutions have been published for mini-PCNL procedure, this is the first study that compares Amplatz and metallic sheaths. This study shows that there is no difference between the two groups in terms of final stone-free rate and complication rate. Even though the indications of each dilatation technique were similar, metal sheaths are most cost-effective (6.1 vs 63 Euro per case; p < 0.001).